CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

THIS PRESENTATION INCLUDES DEFINITION, AETIOLOGY, CLINICAL PRESENTATION, CLINICAL FEATURES, MOCK ASSESSMENT AND PT MANAGEMENT OF COPD. THIS PPT IS MADE FOR ONLY LEARNING PURPOSE AND FOR EXAM PURPOSE.

1. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) DR.SAMIR JADAV (PT)

2. CONTENTS DEFINITION AETIOLOGY CLINICAL PRESENTATION CLINICAL FEATURES ASSESSMENT (MOCK) PT MGMT

3. DEFINITION Chronic obstructive pulmonary disease  ( COPD ) is an ill-defined term that is often applied to patients who have combination of chronic bronchitis and emphysema which frequently occur together. It is disease characterized by persistent airflow limitation that is usually progressive

4. AETIOLOGY Cigarette smoking Occupational exposure Air pollution Genetics Autoimmune disease, etc.

5. CLINICAL PRESENTATION COPD is a complex interaction b/w ASTHMA, BRONCHITIS and EMPHYSEMA. CHRONIC BRONCHITIS :- Acute bronchitis is the acute inflammation of bronchial tree. Chronic bronchitis is a chronic or recurrent increase in the volume of mucus secretion sufficient to cause expectoration.

6. 2) EMPHYSEMA Emphysema is a condition of the lung characterized by permanent dilatation of the air spaces distal to the terminal bronchioles with destruction of the walls of these airways.

7. CLINICAL FEATURES Dyspnoea Cough Sputum Wheeze Barrel chest Cynosis Cor pulmonale Chest tightness Weight loss Respiratory infections

8. ASSESSMENT (MOCK) DEMOGRAPHIC DETAILS CHIEF COMPLAINTS - Patient complaints of cough, difficulty in breathing. - patient also complaints of blood in sputum sometimes. HISTORY H/O PRESENT ILLNESS: - H/O of recurrent pulmonary infections.

9. PAST MEDICAL HISTORY - No other medical conditions in past. DRUG HISTORY FAMILY HISTORY - Present SOCIAL HISTORY - patient may not fullfill the social requirement of his/her family. PERSONAL HISTORY - (smoke, alcohol)

10. SUBJECTIVE ASSESSMENT COUGH : Chronic Productive DYSPNOEA : Present Grade-1(NYHA scale) SPUTUM : Mucoid HAEMOPTYSIS : Not Present WHEEZE : Present OTHER SYMPTOMS : Fatigue, weakness present.

11. OBJECTIVE ASSESSMENT GENERAL OBSERVATION - Patient seems to be breathless. LEVEL OF CONSCIOUSNESS - GCS scale BODY BUILT OBSERVATION OF CHEST CHEST SHAPE :- Barrel chest CHEST MOVEMENT :- Bilateral diminished BREATHING PATTERN :- According to gender TYPE OF BREATHING :- Obstructive breathing POSTURE - Exaggerated kyphotic and lordotic curve.

12. ON EXAMINATION (VITALS) TEMPERATURE :- Normal RESPI. RATE :- Tachypnea HEART RATE :- BLOOD PRESSURE :- ON PALPATION TRACHEA : Normal/Central TENDERNESS : Absent TVF : Reduced CHEST EXPANSION : Hyper-inflated

13. ON PERCUSSION - Hyper resonant type on percussion. ON AUSCULTATION -BREATH SOUNDS : Vesicular -FOREIGN SOUNDS : Wheeze, INVESTIGATIONS

14. CHEST X-RAY : Flattening of diaphragm Chest hyperinflation. ABG ANALYSIS : Low PaO2 due to Va /Q mismatch. Increased PaCO2 LUNG FUNCTION TESTS : Decreased FEV1/FVC ratio Increased TLC, FRC, RV due to overinflation of lungs. 6-MINUTE WALK TEST : Reduced ex. tolerance DIAGNOSIS : COPD PT MGMT - SEE ‘PULMONARY DISEASE PT MGMT’ PRESENTATION.